Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $19.05 / $19.05 / $169.82	Facility	26	$19.05	$19.05	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $52.48 / $85.11	Professional		$30.20	$52.48	$85.11
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $18.20 / $21.38 / $54.95	Professional	26	$18.20	$21.38	$54.95
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $8.91 / $30.90 / $46.77	Professional	TC	$8.91	$30.90	$46.77
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $21.88 / $58.88 / $123.03	Professional		$21.88	$58.88	$123.03
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $19.05 / $19.50 / $33.88	Professional	26	$19.05	$19.50	$33.88
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $10.00 / $36.31 / $39.81	Professional	TC	$10.00	$36.31	$39.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $83.18 / $223.87	Professional		$43.65	$83.18	$223.87
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $22.39 / $38.02 / $87.10	Professional	26	$22.39	$38.02	$87.10
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $13.18 / $38.90 / $138.04	Professional	TC	$13.18	$38.90	$138.04
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $60.26 / $123.03	Professional		$50.12	$60.26	$123.03
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $19.50 / $22.39 / $45.71	Professional	26	$19.50	$22.39	$45.71
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $30.90 / $38.02 / $79.43	Professional	TC	$30.90	$38.02	$79.43
United Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $47.86 / $134.90	Professional		$26.92	$47.86	$134.90
United Facility/Professional Professional Modifier 26 Low / Median / High Price $17.38 / $25.70 / $57.54	Professional	26	$17.38	$25.70	$57.54
United Facility/Professional Professional Modifier TC Low / Median / High Price $9.77 / $25.12 / $75.86	Professional	TC	$9.77	$25.12	$75.86